Guiding Transformation: How Medical Practices Can Become Patient-Centered Medical Homes

This report outlines and describes the changes that most medical practices would need to make to become patient-centered medical homes. The broad "change concepts," as the report terms them, include: engaged leadership; a quality improvement strategy; empanelment or linking patients with specific providers to ensure the continuity of the patient–provider relationship; continuous and team-based healing relationships, including cross-training staff to allow team members to play various roles; organized, evidence-based care, including the use of decision support systems; patient-centered interactions to increase patients' involvement in their own care; enhanced access to ensure patients have access to care and their clinical information after office hours; and care coordination to reduce duplication of services and increased anxiety and financial costs for patients and their families.